This is not the state's healthiest corner. In fact, health outcomes in this region are among the worst in all of North Carolina.
In Robeson County, outcomes are the worst in the state, according to the annual County Health Rankings Report compiled by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. It's a deadly problem.
The differences between the healthiest counties and the least healthy are dramatic. If you live in Robeson County, you've got nearly a three-times-greater likelihood of premature death than if you live in Wake County, the state's healthiest. In Wake, 13 percent of the residents are in poor or fair health. In Robeson, it's 29 percent. The average Robeson resident has nearly twice as many "poor physical health days" as a Wake resident. The disparity in "poor mental health days" is only slightly smaller. Twelve percent of the children in Robeson come into this world with low birthweight, while in Wake, it's 8 percent.
While health outcomes in Robeson are the worst in the state, the county has plenty of company across this region. Scotland ranks 99th, only one position behind Robeson. Columbus is 96th and Bladen is 95th. Only Moore County ranks among the healthier of counties, coming in at 22nd in the state — a remarkable position, given the numbers of retirees who live there. But health care in Moore is plentiful and good, and residents are better able to afford it than in many neighboring counties.
Cumberland comes in at 75th in the state for health outcomes, the worst ranking of any of the state's urban counties. This should be alarming to local leaders, and to the county's problem-plagued Board of Health.
There is a significant common thread in these poor health outcomes: poverty. Health, in most cases, correlates fairly directly with wealth. Wealthier counties tend to have the best-rated health-care facilities and practitioners and plenty of them — and more people with health insurance and the ability to pay for good care. Smoking rates tend to be lower in wealthier counties and exercise rates higher. A wealthier, better-educated population is more likely to understand the basics of good nutrition and better able to access fresh, nutritious food.
The health-outcomes survey is one more reason why poverty-fighting initiatives in this region are so important, as are efforts to attract new, better-paying business and industry. We know, as well, that there are no magic bullets out there for banishing poverty from our communities, any more than there are secret routes to better education. But it's work that must be done.
The poor health of many communities in this region should be prominent on state government's radar, because an impoverished, unhealthy population is an expensive population. Poor people plagued by ill health are expensive. They're likely to get their health care from hospital emergency rooms, at a point when their illness has progressed and treatment is the most costly. Those medical expenses are largely borne by the taxpayers, whether it's through free-care clinics, the emergency departments or other public avenues.
With Cumberland in 75th place in North Carolina health outcomes, this should add a greater sense of urgency to the county's search for a new health director and a better way to manage and oversee the Health Department. It's clear that more public outreach is in order, more programs that get county residents into regular, routine health care. It tells us why we need better nutrition education and efforts that make good food available to residents who live in poverty.
And for the poor, rural areas around us, the health rankings are a reminder that the state has largely abandoned its rural counties. The economy may be booming across North Carolina, but in places like Robeson, Scotland and Columbus, residents know that prosperity has passed them by. So has good health. Will government move to level the opportunity for good health?